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36months

INITIAL HISTORY

MEASUREMENTS:

  • Length/Height and Weight
  • Blood Pressure
  • BMI

SENSORY SCREENING

  • Vision/Hearing

DEVELOPMENTAL/BEHAVIORAL HEALTH

Psychosocial/Behavioral Assessment: Pediatric Symptoms Checklist (PSC)

Developmental Surveillance: DENVER

Nutrition

Discuss With Parents

  • Increasing their child’s awareness of new foods by making sure the child sees family members and friends trying and enjoying them.
  • Teaching their child about new foods by growing, preparing, and talking about them.
  • Sharing stories, drawing pictures, and singing songs about food to help their child become familiar with them.
  • Helping their child become more fit (stability, agility, endurance, and coordination).
  • Turning off the television during mealtimes.
  • Limiting total entertainment media time (watching television, playing computer or video games) to no more than 1 to 2 hours of quality programming a day.
  • Encouraging interactive activities (talking, playing, singing, and reading together).

PHYSICAL EXAMINATION

PROCEDURES:

Immunization (flu)

Influenza: This infection causes high fever, chills, severe muscle aches, headaches, pneumonia, swelling of the brain and death. There are still thousands of deaths every year in the U.S. from influenza related complications

  • Lead testing (if risk factors)
  • Anemia (if risk factors)
  • Tuberculosis

ORAL HEALTH

Fluoride Varnish

ANTICIPATORY GUIDANCE

  • The first priority is to attend to the concerns of the parents. In addition, the Bright Futures Early Childhood Expert Panel has given priority to the following topics for discussion in this visit: Social determinants of health: Risks (living situation and food security; tobacco, alcohol, and drugs), strengths and protective factors (positive family interactions, work-life balance)
  • Community agencies can help you with concerns about your living situation.
  • Programs like WIC and SNAP are available to help you if you have concerns about your food situation.
  • Don’t use tobacco/e-cigarettes/alcohol/drugs. Call 800-QUIT-NOW (800-784-8669) for help to quit smoking.
  • Show affection in family; handle anger constructively; give child opportunities to make choices.
  • Take time for self, partner; create opportunities for family to spend time with the child.
  • Playing with siblings and peers: Play opportunities and interactive games, sibling relationships
  • Encourage play with appropriate toys and safe exploration; expect fantasy play.
  • Encourage interactive games with peers; explain importance of taking turns.
  • Help your children develop good relations with each other.
  • Encouraging literacy activities: Reading, talking, and singing together; language development
  • Read, sing, play rhyme games together; let child “tell” story; practice reading wherever you go.
  • Encourage child to talk about friends, experiences.

Promoting healthy nutrition and physical activity

  • Water, milk, and juice; nutritious foods; competence in motor skills and limits on inactivity
  • Always have cool water available.
  • Provide 16 to 24 oz low-fat/fat-free milk daily.
  • Juice is not a necessary drink. If you choose to give juice, limit to 4 oz daily and always serve it with a meal.
  • Offer variety of healthy foods/snacks, especially vegetables, fruits, lean protein. Trust child to decide how much to eat.
  • Encourage opportunities for physical activity for child, family.
  • Limit TV and other digital media to no more than 1 hour a day; monitor what child watches; consider making a family media use plan ( www.healthychildren.org/MediaU... ).

Safety

  •  Car safety seats, choking prevention, pedestrian safety and falls from windows, water safety, pets, firearm safety
  • Continue to use properly installed, size appropriate rear-facing or forward-facing car safety seat with 5-point harness. Keep car safety seat in the backseat.
  • Prevent choking by cutting food into small pieces.
  • Supervise all play near streets/driveways; don’t allow child to cross street alone.
  • Move furniture away from windows; install operable window guards.
  • Provide “touch supervision” near water, bathtubs, pools, toilet.
  • Teach child about safety around pets.
  • Remove firearms from home; if firearm necessary, store unloaded and locked, with ammunition locked separately; ask if firearms in other homes where child plays; if so, ensure same safety precautions are used before letting child play there.

Anticipatory Guidance

Phone Line Hours

Monday:         7:30am - 4:30pm
Tuesday:         7:30am - 4:30pm
Wednesday: 7:30am - 5:30pm
Thursday:      7:30am - 4:30pm
Friday:             7:30am - 11:30am
Saturday:      7:30am - 11:30am

Office Hours

Monday:         7:30am - 4:30pm
Tuesday:         7:30am - 4:30pm
Wednesday: 7:30am - 5:30pm
Thursday:      7:30am - 4:30pm
Friday:             7:30am - 11:00am
Saturday:      7:30am - 11:00am

Lunch Hours

Monday - Thursday
11:00am - 1:30pm

Our Location

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